How do I know if I have a full thickness rotator cuff tear?

Author: Howard J. Luks, MD- Posted in: Rotator Cuff, Shoulder, Shoulder FAQ 126 Comments

While full thickness rotator cuff tears are very common, let’s back up and start with the basics about these 4 little muscles.  The rotator cuff plays a key role in the proper function of the shoulder.  The rotator cuff can be a source of pain for many many reasons.  Pain can be due to inflammation, degeneration or tears of the rotator cuff.  Tears of the rotator cuff come in all shapes and sizes.  Fraying of the rotator cuff tendon surface, partial thickness tears, and full thickness rotator cuff tears are all quite common.

How do Orthopedists figure out which one you have and how does that effect our treatment strategies?

Rotator Cuff Tears:

Before we delve briefly into whether or not you have a full thickness rotator cuff tear (complete tear),you need to know what the rotator cuff is. 

Full Thickness Rotator Cuff Tear

Full Thickness Rotator Cuff Tear

  The rotator cuff is a series of four muscles, which combine at the shoulder to form a cuff of tissue completely surrounding the top of the arm bone or humerus.

Rotator cuff tears can be described in many different ways.  

  • There are traumatic tears (accident or a fall), acute tears (just happened)
  • Chronic tears (present for a while, you just didn’t know it)
  • Degenerative tears ( your tendon just wore out).

Rotator cuff tears can also be described as being partial, or full thickness.  With partial thickness rotator cuff tears  only part of the tendon has torn off the bone.  With full thickness tears the entire tendon has separated or torn from the bone.  Click here to learn about partial thickness tears.  

Can you tell if you have a full thickness rotator cuff tear?

After a significant trauma such as a fall or a car accident, your rotator cuff tendon can literally pull right off the bone.  We call that an acute, traumatic full thickness rotator cuff tear.  On the other hand, I see many patients in the office who do not recall any significant injury, but their exam and MRI demonstrate that they have a full thickness tear — why is that? The risk of developing a rotator cuff tear increases with age because our tendons begins to gradually wear, lose its blood supply and its resilience. In that situation, even routine daily activities like gardening or working around the house  increase the potential for wear, degeneration, and tearing.

 

 

 

Whether your tear is chronic, attritional (wear and tear) or acute and traumatic (fall or injury)  is a VERY important element of the decision making process in how we treat full thickness rotator cuff tears.   Treatment decisions are based not only on the type of tear you have, but whether or not other treatments have failed, and how poor your quality of life is. 

Full thickness rotator cuff tears

Rotator cuff tears come in all shapes and sizes.  Many patients have full thickness rotator cuff tears and do not even know it.  As a matter of fact, by the time you reach 65 you have more than a 50% chance of having an degenerative rotator cuff tear because of wear and tear.   No need to panic…

How can Orthopedic Surgeons tell if you have a full thickness rotator cuff tear?   

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Shoulder Pain:  

Does the amount of pain you are having correlate with the size or thickness of your rotator cuff tear?

The size of the tear usually doesn’t correlate with the pain you are experiencing.  Many patients mistakenly believe that they must have a large full thickness rotator cuff tear because they are in severe pain … usually the opposite is true.   Many patients with severe shoulder pain have very small full thickness rotator cuff tears,  partial thickness rotator cuff tears, or no tear at all.   Yet some patients with mild shoulder pain have massive rotator cuff tears.  Bottom line… the size of your tear will not correlate with the amount of pain you are experiencing.  Many patients with tendonitis or bursitis have more pain than patients with rotator cuff tears. Many patients with tendinosis, small tears, large tears or just bursitis usually have very severe pain at night.   Night pain can be very disruptive, aggravating and demoralizing.  Night pain is frequently the reason many patients cite why they opted for surgery to repair of a full thickness rotator cuff tear.

Stay ahead of the latest news regarding Rotator Cuff Tears by clicking here to receive our Sports Medicine Blog posts.

Weakness:

The rotator cuff muscles control the motion and the overall strength of the shoulder.   Small tears do not produce shoulder weakness, however,  large or massive tears can produce very significant shoulder weakness.

Patients with large rotator cuff tears complain of weakness and the inability to place the arm in certain positions.  They have difficulty taking milk out of the refrigerator and may need to support their injured arm with their other arm when attempting to lift something.   

Loss of motion:

Most rotator cuff conditions which produce pain will lead to loss of motion.  Many patients with rotator cuff related pain will complain of difficulty with hair care, putting on a bra or belt, and weakness when trying to lift the arm away from the side. Sometimes patients with full thickness tears will have significant loss of motion, and sometimes patients with large rotator cuff tears will have normal motion.  That means that loss of motion, in general, is a poor predictor in and of itself of the presence of a full thickness rotator cuff tear.  

A thorough physical examination by a Sports Medicine trained specialist is usually necessary to determine whether a rotator cuff tear is present.

Ultimately an MRI or an ultrasound may be necessary to confirm the presence and size of a rotator cuff tear and determine if it is partial thickness or a full thickness rotator cuff tear.

Whether you have a full thickness tear or a partial thickness tear, your pain may be so severe that your quality of life if very poor. You’re not sleeping well and you have very limited use of your arm.  Not all tears require surgery… but some do.  Click on the the Book an Appointment button below and let’s discuss what treatment option best suits your needs.  

 


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126 Responses to “How do I know if I have a full thickness rotator cuff tear?”

  1. Reply Teresa says:

    is it always necessary to fix a full-thickness tear, even if it is very small?

    I find it extremely difficult to understand how a very tiny (but full-thickness) tear could never heal on its own — yet that is what my ortho keeps telling me. It seems to me, that all the extreme damage caused by surgically repairing such a tear would actually be worse than letting it slowly heal.

    Another comment about the pain issue — i have been told that the inflamation around my “tiny” tear is what is causing the massive amounts of muscular spasms and cramping under my shoulder blade and down the back. I had no idea the two were even related until a cortisone shot to the shoulder stopped just about everything in the upper back.

  2. Reply Howard J. Luks, MD says:

    Generally speaking… and I must add that my disclaimer must apply :-(
    All full-thickness rotator cuff tears do not need to be fixed. Some will become larger with time, some will not. We can not predict which ones will become larger. Surgery to prevent progression is probably not a wise move. Small tears can heal. Although larger ones, can not. The inflammation can be due to many things around the shoulder and may or may not be related to the tear. Injecting cortisone also alters the healing environment within the shoulder… making it less likely that a repair would be successful if you chose to have surgery.

    Bottom line… many full thickness “very small) tears, and even some larger ones do not need to be fixed. We treat patients and not MRIs. If PT and injections work to alleviate pain… then it is usually OK to stop there.

  3. Reply kathy says:

    I have a tear in rotator cuff and bone spurs one on top of rt should that is growing. I have no pain from the cuff just knot that is on top. I can move my arm up over my head, and up behind my back with no pain The dr want to do surgery on it . I would like to wait.

    • Reply Howard J. Luks, MD says:

      This is such a common question… and there is no easy answer. Do all rotator cuff tears *need* to be fixed… no. Do some tears need to be fixed, yes. Many attritional tears (where the tissue simple wears out) can be observed or watched for years. Many people are walking around with torn rotator cuff tendons and don’t even know it! There is a body of evidence showing that some (attritional) tears are simply a consequence of genetics or aging. You need to have a sit down with your surgeon or perhaps a second opinion and see why he/she is recommending surgery. Bone spurs are not a reason to have surgery…. that theory has been falling out of favor for years. Your surgeon should be able to give you a rational reason why the tear “needs” to be fixed. If it is an attritional, small tear, and you have no pain — you should be satisfied with his/her reasoning why they want to subject you to a painful procedure with a long recovery. A shared decision making process also takes into account your values, and the affect that you feel the tear is having on your quality of life. After you have heard the rationale and incorporated other shared decision making principles, then you can make a choice on how to proceed. I hope this helps.

  4. Reply Name Keisha says:

    I fell exactly three years ago and injured my shoulder. I went straight to the emergency room for an xray, which came up negative and the doctor told me that my ligiments were stretched to the max. He prescribed something for the pain and swelling. Now three years later my shoulder is badly hurting. It hurts mostly at night or if I lift my arm above my head, however lifting small things such as a gallon of milk does not hurt. Does this sound like I have a torn rotator cuff? Thanks

    • Reply Howard J. Luks, MD says:

      Keisha… It’s impossible to say whether or not you have torn your rotator cuff, but it does *sound* like your rotator cuff is the source of your pain. Not all rotator cuff pain is because of rotator cuff tears. Tendinosis or inflammation can hurt just as much, if not more.

      Time for a good exam and perhaps further imaging.
      Good Luck

      Howard Luks

  5. Reply Michael says:

    Howard,

    I did something to mine on 8/27 of this year. That night and for the next 6wks I could not lift my arm. I had ROM from where my elbow could bend but that was it :/

    3months later I have a little bit of the ROM back and from reading a post above I thought my back was spasm out due to possibly overcompensating with one side of my body. from my shoulder, where the injury is, and down both sides of my back it is horriable pain.

    I addressed it with my ortho and he prescribed more PT awaiting the results of the MRI.
    Are the 2 not related, the injury to the rotary cuff and the back spasms, tension?

    Thanks in advance,

    Michael

    • Reply Howard J. Luks, MD says:

      MIchael… sometime when our shoulder is bothering us… and we do not move it “normally” we start to compensate and it can cause the muscles around the scapula to become sore or bothersome…

      Howard Luks, MD
      Westchcester County, NY

    • Reply Howard J. Luks, MD says:

      Michael… When our shoulder bothers us and doesnt move properly, we tend to compensate by using our scapula muscles in a manner they are not used to. That can cause spasm in the region around your shoulder blade (scapula). There are also other reasons to have spasm in that region … and that could potentially be related to you initial injury too.

      Keep us informed.
      Howard Luks, MD
      Westchester County, NY

  6. Reply Jonny says:

    Hey Howard,

    My shoulders hurt a lot when I raise my arms to the side for too long. Perhaps only a minute before it starts to ache. Both also dislocate and rejoin when I bend my elbow and move my shoulders backwards. Its this a sign of a large tear? I have had this for a year now.

    • Reply Howard J. Luks, MD says:

      J,
      Shoulders can dislocate for many reasons. Loose ligaments, torn ligaments and very large rotator cuff tears. Pain with instability (dislocations) is not unusual because your muscles around the shoulder are working very hard to try and keep the joint stable and located. A complete history (your story), a good physical exam and perhaps an MRI will give you a reason why your shoulders are dislocating and why you have such pain.

      Howard Luks, MD
      Westchester County, NY

  7. Reply The Rotater and Customer Service | theRotater.com says:

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  8. Reply NameDiane says:

    I fell 4 wks. ago,and had an MRI done early July. Dr. sais to try physical therapy. Today, the therapist siad I have a full thickness tear,and,should consult witha surgeon! Is she qualified to read the
    MRI report?
    Thanks,so much!

  9. Reply keon says:

    i was benching about 95lb because it was my first time. then i heard tearing or popping on my right shoulder. it did not hurt for 2 days but just sore and on third day i went to play basketball with my friends and that night my shoulder pain was so great that i couldnt go to sleep. the pain went away after 3days. the only thing that is bothering me is little discomfort in my right shoulder. i did some online research and im really confused. i have full range of arm motion and the pain was in front of my right shoulder. Could this be a large rotator cuff tear?

    • Reply Howard J. Luks, MD says:

      Could it be, yes… is it likely, no. AS I say throughout my site, some people with large tears have moderate, mild or no pain — and some people with severe pain can’t sleep and complain of severe pain with active use. The amount of shoulder pain that someone has does not correlate with the size of their tear.

      Hope this help~!
      Thanks for your commments
      HJL

  10. Reply keon says:

    also my shoulder feels a little weak compared to my left one.

  11. Reply Jim says:

    WIth a full thickness tear, how long does one typically have before the tendon retracts or the body turns the tendon to fat?

    Thank you in advance for your comments?

    • Reply Howard J. Luks, MD says:

      Welcome Jim … great question. Tendon retraction occurs in large tears involving one or more of the 4 rotator cuff muscles (and tendons). Many tears are small and recent literature has shown that they do not increase in size or retract. Fatty atrophy, where the muscle turns to fat is an interesting phenomena. It also tends to occur with larger tears. The sad thing is some studies show that it worsens after a repair, and never reverses back into a normal muscle after it has occurred.
      Hope that answers your question.
      Howard Luks MD

  12. Reply Karidene Eaton says:

    I have recently found that I have lost significant range of motion in my right arm, I cannot raise my arm fully over my head, yet there is no pain at all. Is it possible that I have a torn rotator cuff of some sort?

    • Reply Howard J. Luks, MD says:

      Could be related to your rotator cuff or something we call a frozen shoulder. Other less common diagnoses possible. Time to see a good shoulder surgeon.

      Good Luck
      Howard Luks MD

      • Reply NameEddie says:

        M right should tip bone is higher than my left. I have no pain, when I raise my arms straight out I have a bigger hole(void) on my right shoulder than my left. I hurt my shoulder 20yrs ago playing softball diving for a ball, jamming my shoulder upward. I had it checked out but no surgery. I had no pain lifting and had complete motion, the only time would be when I throw a ball. That is doing a full throw, but if I only cocked my arm halfway back I have no pain. I fell a month ago mtn biking, and this is the time I noticed the void and my right shoulder higher than my left. I stll have no pain and full range. Please advise.

  13. Reply Names Sharon says:

    I have tears in both shoulders, now doctor said i have bone spur in left one. If he fixes bone spur and don’t have to fix tear will the pain just go away from the top of my shoulder or will it help the pain in the front of my shoulder which I think is from the tear. I have already gone through pt.

    • Reply Howard J. Luks, MD says:

      Thanks for stopping by Sharon… the thought that a “bone spur” is the source of shoulder pain started to die away as a concept many many years ago. Today, most academic shoulder surgeons very very rarely go after bone spurs or look at them as a source of pain.

      I wish you luck in your pursuit for pain relief!
      Howard Luks

  14. Reply Names Sharon says:

    Hi Sharon again, that is what mt doctor said. He did a MRI back in August, then sent me to pt. never did he talk about this bone spur just the tears. Now since doing pt since August and still having pain, I went back to him to see what to do. Now all of a sudden he tells me I have a bone spur, and if I can’t live with the pain he will do surgery.. It bothers me that he didn’t talk about this bone spur before. Why would he not had talk about the spur right from the get go, and should I do the surgery. It sounds like he will go in and clean up the bone spur, and said while he is in there look at the tear see how it looks. His main reason is bone spur, what odd you think???

    Thanks!!!!

    • Reply Howard J. Luks, MD says:

      I would be wary about anyone talking bone spurs as the source of pain… as I mentioned in my last response… the thought that they cause shoulder pain has really fallen out of favor.

  15. Reply Names Sharon says:

    Wow really, because yes that is what he is saying, bone spur, if I can’t live with the pain then have the surgery, 94 to 95 percent the pain will be gone, no talk about the tears..

    Don’t know what to do…

    Thanks…

  16. Reply Tony says:

    Dr. Howard,
    I have had shoulder pain for over a year now, and I think it came from weight lifting. I am a heavy lifter and play football, and for the past year it has pained me to lift heavy bench, shoulder workouts, push press, pretty much any motion lifting my arms or holding something out in front of me. I am now a college athlete, and really need to figure out what is wrong. I feel it in my side delt mostly, sometimes in anterior delt as well. Do you have any ideas?
    Thanks

    • Reply Howard J. Luks, MD says:

      Pain in the shoulder in young athletes is typically from the AC Joint, a labral tear or a rotator cuff overuse injury. It is almost never due to a rotator cuff tear. Without evaluating you I really can’t offer an opinion as to why your shoulder is bothering you. I hope you are able to find a great sports doc who can assist you!
      Howard Luks

  17. Reply Tony says:

    it is my right arm

  18. Reply Bob says:

    I have 3 tears in my rotator cuff from a fall and a possible tear in the labrum i have constant pain over the top of the humeral head. I wake 4 times a night to move my arm to where it feels more comfortable. I have done PT for 5 months to no avail pain is still there and can not regain strength. Could surgery help me regain my strength and reduce the pain?

    • Reply Howard J. Luks, MD says:

      It’s certainly possible… the success rate in terms of pain relief is very high but the success rate is also determined by a number of factors such as the size of your tear, the degree of “retraction” or “atrophy” as well as other factors. Time to have a meaningful sit down with your surgeon to discuss the alternatives.

      Good Luck

  19. Reply Lisa says:

    I have been having pain in my shoulder for 3-4 years. I had the pain treated twice with oral steroids. Recently, was in excruciating pain and called an orthopedic doctor. The MRI results were…Focal near full-thickness rotator cuff tear. Also states in the summary 3 mm gap at the site of the tear, along with findings of calcific tendinitis. I’m not sure if I should get a second opinion. I’ve already scheduled surgery for March 20th. Is it possible that the tendinitis is causing the pain and not the tear? I forgot to mention that I went through three months of physical therapy recently and it did not help. Pain when moving my arm up and pain at night. Any suggestions??

    Thanks,
    Lisa (46 years old)

    • Reply Howard J. Luks, MD says:

      In all likelihood it is the calcific tendonitis that is producing the pain… but without examining you it is impossible to know for sure. Many many of us have had significant success with Ultrasound guided injections of the calcium deposit which washes the deposit out of your shoulder… thus eliminating the need for surgery. Most academic shoulder surgeons typically do not get very aggressive with tiny rotator cuff tears… although we do watch them to make sure they do not become larger (most do not).

      Good Luck
      Howard Luks MD

  20. Reply Kyla says:

    Hello Dr. Luks,

    I have gone to doctors office several times about my shoulder and I have seen an Orthopedic as well. But nobody has figured out why my shoulder hurts. I have gotten contrast with my MRI and nothing. But i recently hurt my shoulder again. And now I am experiencing numbness down my arm and I am afraid that the doctors will tell me the same thing as before. Also, my body does not show tears… I know that may sound silly but it’s true. I injured my knee in high school and the orthopedic did not even see it until he went in and saw a tiny tear. I have tried Physical therapy but that just bothers it and it hurts more. So I guess my question for you is what do you think my problem is? Thank you!!

    Kyla

    • Reply Howard J. Luks, MD says:

      I wish I could tell you Kyla! It’s in situations like this that a thorough history and physical exam is of paramount importance. MRIs should be used to confirm diagnoses around the shoulder… not necessarily to make the diagnosis.

      Good Luck !

      Howard Luks

  21. Reply Tonya Owens says:

    I am 34 years old and had shoulder impingement following a minor motor vehicle accident in 2009. Had subacromial decompression in 02/2011…did well until about 6 months ago when I tried regularly incorporating exercise (small hand weights). Mri from November showed arthritis, bursitis, tendinitis and a small tear on my right, dominant shoulder (sup. tendon). My pain has gotten progressively worse and now at night it can be excruciating. My ortho is hesitant to do surgery due to my age and sending me to Gerald Williams at the Rothman Institute. I don’t want my age to be the sole factor in not doing surgery. Any thoughts on this.

    • Reply Howard J. Luks, MD says:

      Age should not be a significant factor in treatment decisions about rotator cuff related issues. Good luck with your visit with Dr Williams.

    • Reply Howard J. Luks, MD says:

      Your age will have nothing to do with whether or not surgery, therapy or injections are recommended. Good luck!

  22. Reply NameBarry says:

    Dear Dr. Luks. Your posts are so helpful and I appreciate your caring responses. Does some fraying or partial thikness tear of SP tendon have a high likelihood of becoming a full thickness tear in a 40 + year old with an active shoulder, i e. regular exercise and strengthening or some weightlifting regimen? Is anything beyond physical therapy and better form or guided exercise to do to prevent chance of progression? Thanks very much.

  23. Reply Denise says:

    I cannot lift my arm upright at all and have really bad pain. Arm is useless and even hurts to type. Is there anyway to get out of this without surgery/ Ouch!!

    • Reply Denise says:

      Oh forgot to say I fell in the market and heard the tear

      • Reply Howard J. Luks, MD says:

        Denise… I’m not sure what you’re suffering from :-( Did your Orthopedist say you have a tear? Did an MRI or ultrasound confirm that? Orthopedists tend to treat acute or traumatic tears differently than most tears which are degenerative (where out tissue simply wore out).

  24. Reply Mark says:

    Dr Luks, First of all thank you very much indeed for your time in answering questions online – it is most kind and helpful of you for what are often worrying things for people.

    I had rotator cuff surgery 9 or so weeks ago on a full thickness 2.5 cm tear on my supraspinatus tendon. The surgeon tells me the repair was very tight and reliable. The shoulder was very stiff after surgery, partly from before surgery due to freezing or adhesions I am told. Quite aggressive stretching prescribed by the surgeon and my physiotherapist has now freed this up a good deal happily. In general things seem to be progressing well, with light strengthening exercises now started.

    My question is. I find after raising my arm above my head with a light weight that when I lower my arm the shoulder “clicks” very slightly but noticeably when I lower the hand to about shoulder level. This is like a tendon moving over or flicking over something and seems in the region of the supraspinatus closer to my neck (I think) than my shoulder (but I can’t be sure exactly of the source of course), I don’t get undue pain with this and strength and movement seem to be coming back slowly. Should I be concerned about this “clicking” or is it more likely just a part of recovering the healthy structure of the shoulder rather than an issue with the repair or something else I should be concerned about. I did ask my physiotherapist but she was not sure but suggested it was probably nothing to worry about.

    Obviously I will not take your response to be a definitive answer about my shoulder, but any advice on this kind of thing in general based on the symptom would be greatly appreciated. Thank you again

    • Reply Howard J. Luks, MD says:

      Clicking in the shoulder is very common.. especially after a rotator cuff repair. As long as things are progressing well it should not be a problem.
      Good Luck …
      Howard Luks

  25. Reply Sam says:

    Hi, I wana know which one is better an Ultra sound or an MRI to find out if its a rotator cuff tear? and Does jus givin proper rest to the shoulder help the rotator cuff to heal on its own?? Thanks and god bless.

    • Reply Howard J. Luks, MD says:

      If the person doing and reading the Ultrasound is good… it is as good as an MRI in evaluating the rotator cuff.

  26. Reply Kumar (India) says:

    Please tell me, how much time does it take to fully recover from a shoulder impingement syndrome?
    I am 35 yrs of age and getting treatment for Shoulder impingement for last 4 months. Thanx

  27. Reply Kumar says:

    Please tell me, how much time does it take to fully recover from a shoulder impingement syndrome?

    I am 35 yrs of age and getting treatment for Shoulder impingement for last 4 months. Thanks

  28. Reply tom parker says:

    hi i have loud cracking in my shoulder when i stretch or do weights i dont know what it is thanks help me

  29. Reply Mark says:

    Hi Dr Luks you kindly answered my question about clicking in my shoulder after having had surgery to reattach my supraspinatus tendon. Your answer was reassuring. I have realised now though that there is also a very slight movement at the point of the shoulder where I think the supraspinatus tendon would have been attached to the bone. This happens when I raise my arm above my shoulder and is more marked when I am holding a light weight as I have been asked to do for therapy. I am now almost 12 weeks from having the surgery. There is little or no pain associated with this although sometimes the shoulder Is slightly sore overnight. The movement itself seems to be quite slight, as if the tendon or perhaps just part of it is repositioning slightly under the slight strain of weight and movement.

    I wonder if you could indicate whether you think this could also to be quite normal in the lengthy healing process. My hope is that some movement under stress is not uncommon at this stage but that given care and rest this will also settle down. It does tend to make some alarm bells ring for me though and tends to make me want to ease up on raising my arm a little and to use only the lightest weights at the moment.. again in the hope that the fix will settle down more in time.

    I would be greatly appreciate any thoughts you have. Thanks once again.

  30. Reply Mark says:

    The question I asked regarding apparent movements of the tendons near the surgery site were probably hard to answer realistically without knowing my progress in detail. Time has passed with my shoulder rehab since my query and I am pleased to say now that the movement and noise has settled down almost completely – still quite a way to go and the shoulder is stiff and not as strong as it should be yet, but he issue I had with tendon movement and so on has greatly reduced as the shoulder gets stronger. Thanks again

  31. Reply Partial Rotator Cuff Tears --Jonathan Niese and You - Howard J. Luks, MD says:

    [...] We actually refer to these as partial “thickness” rotator cuff tears, as opposed to full thickness rotator cuff tears. [...]

  32. Reply Matthew Coriell says:

    I have a question, I hurt my shoulder a year ago, tubing when I fell on it outstretched. I work out with high intensity. I started crossfit about 4 months ago, and I think from just over use it has came back the pain. It hurts when I put on a belt from behind me. I went and did an MRI and it showed a lot of inflammation in my shoulder, also a slight tear on labrum and rotator cuff. My doctor told me to stay off for 6 weeks, which I did, but now I’m back working out and it is still aching. It doesn’t really hurt, it’s just a deep ache I feel like in there. I want to compete in Crossfit, I enjoy everything about the sport, and I’m wondering if I’ll ever be 100%, should I get the surgery even if I’m out for 6 months, and come back to crossfit stronger, or do I keep letting it heal, then working out and it coming back. I just feel like overtime it will get worse. Any advice would be great

    • Reply Howard J. Luks, MD says:

      While a recovery is certainly possible with and without surgery — it is by no means a guarantee. I have seen many high level athletes return to sports at 100% strength, endurance etc after this type of injury. Perhaps you need to talk with your surgeon about letting a therapist or trainer guide you in your cuff rehab. Go very slow re: surgery as a treatment plan. Your goals are very precisely defined…. and leave a low margin for success.
      Good Luck
      Howard Luks

  33. Reply Taylor says:

    Hi Doctor Luks, you seem to really know what you’re talking about and I wanted to get a second opinion online before paying the money to consult an orthopedic surgeon.

    I went to see my general practitioning doctor to get an antibiotic, also for about a week my shoulder had begun to seriously hurt. Very badly in the mornings right when I woke up, to the point that towards the end of the week I was waking up every few hours from the pain, or any time I rolled onto that shoulder in my sleep. I was lifting heavy boxes 2 times that week which I’m not exactly used to, and after the second time, two days later was when the SERIOUS pain started.

    Long story short, I saw my doctor and he said that he believes I have a torn rotator cuff in my right shoulder. However because I had been complaining of the pain for about a week, he told me a few exercises to do.

    I did them one time, and it hurt me quite to even do them, I was in tears by the end.

    Now, 2 days later I could not lift my arm in front of me above 45 degrees, or any type of rotation that would rotate forward/up without massive pain. I can’t really hold anything with weight, and have to support that arm with my other arm when I DO need to use it, because it’s my dominant hand!

    I’m very concerned that the exercises he gave me made it much worse and that now it may be a full tear or something.

    I cannot afford X-rays or and MRI as my insurance does not cover it. Of course, if it seems extremely bad and painful after another week or so I plan to see the surgeon regardless. SO, what I’m asking is your opinion on if you think it may be a full tear? I’m really trying to avoid rushing to a surgeon, especially as I just had my wisdom teeth removed 3 weeks ago.

    Thank you so much in advance, (and sorry for the ranting questions! I’m just in a lot of pain and don’t know what else to do.)

    • Reply Howard J. Luks, MD says:

      Taylor… It sounds as if your rotator cuff is bothering you. I would certainly have a set of X-rays performed… but it may be too early for an MRI. The most common cause of shoulder pain is rotator cuff tendinosis or a partial tear. Your exercises may have made your shoulder hurt more… but it didn’t cause a tear. Many people are successfully managed and treated with medications and injections and therapy. In this situation, an MRI might be necessary if something unusual shows up on the X-rays or if you fail to improve with a course of non-surgical management.

      If you do eventually need an MRI shop around. You will be able to bargain for a cash price!

      Good luck!
      Howard Luks

  34. Reply Ryan says:

    Dr. Luks,
    I have been having shoulder “strength/cuff tear” issues for about 3 years. I’m an avid surfer who always wears wetsuits (most fit tight to snug in the shoulders). First pain was in left shoulder, I’ve been participating in yoga and pilates for about 1 year and the left shoulder is almost back to normal! Unfortunately, the right shoulder now has symptoms associated with strength/cuff tears. I believe 90% of my pain is associated with pressure from the wetsuits as the same activities without a wetsuit are almost pain free. Would it be wise to continue the yoga & pilates or start a physical therapy or personal trainer shoulder strength program? Any advice would be appreciated

    Thanks, your site is wonderful

    • Reply Howard J. Luks, MD says:

      Thanks for visiting Ryan… and thanks for the compliments.

      Hard to explain why the wet suit would set off the rotator cuff or other muscles and cause significant discomfort. I usually suggest that someone evaluate you, determine what the source of your pain is. And then help design a rehab program for you that might involve PT, Pilates, yoga, etc. Hard for me to suggest a specific program without examining you… hope you understand :-) !
      Howard Luks

  35. Reply Tracy says:

    Hi Howard

    I started having left shoulder pain about four months ago. I went to an Orthopedic office and was seen by a PA. He took an x ray and diagnosed me with frozen shoulder. He gave me a cortisone shot and sent me to physical therapy twice a week. The cortisone shot did not help at all with the pain. My shoulder is alot more painful. I have been pain non stop.. I now have pain all the way down to my wrist and hand. I can’t hardly sleep or eat because I am in so much pain. My physical therapist thinks there is something else going on either in combination with frozen shoulder or something different than frozen shoulder all together. I have had 18 pt sessions and my shoulder is getting worse. My doctor is finally sending me for an MRI. Does what I am describing sound like frozen shoulder or does it sound like something else in your opinion?

    Thanks
    Tracy

    Thanks

    • Reply Howard J. Luks, MD says:

      Tracy …
      The hallmark of a frozen shoulder is stiffness or loss of motion. Sometime it’s significant. Even when someone else tries to move your shoulder they can’t because the shoulder seems “stuck” in position. If you do not want to move the shoulder because of pain… that might be something entirely different. Frozen shoulders can hurt … A LOT! It’s impossible for me to say whether or not you do or do not have a frozen shoulder… perhaps you want to see a second opinion or go to an office where the physician sees the patient too.

      Good Luck…
      Howard Luks

  36. Reply george mitchell says:

    I am 68 years old .I shoot basketball daily for 1 hour . About 20 years ago i had a bad fall on some ice landing squarely on my left shoulder . Recently I have had it x-rayed ,it was determined I had small bone fragments causing me pain .I have been getting cordizone shots every 4 months for pain . Recently i began physical therapy and it was going well ,but after a day pulling weeds in the garden I had great pain and was unable to raise my arm above my head ..should I get more x-rays an ultra sound ,what do you recommend ? THANK YOU . GEORGE MITCHELL

    • Reply Howard J. Luks, MD says:

      Thanks for stopping by George.
      I’m not quite sure what you mean by bone fragments :-(. Sometimes we get calcium build up inside our rotator cuff tendons. We call that calcific tendonitis. It can be a very painful condition. Sometimes it resolves over time spontaneously and at times we utilize an ultrasound to localize the calcium and wash it out of the tendon with a syringe full of saline or local anesthetic. Perhaps you can ask your doctor for the more formal diagnosis and I can elaborate on that further if necessary.
      Howard Luks

  37. Reply Tim says:

    Dr. Luks, I separated my shoulder years ago (40 or so) when I caught a softball. I dove and was on my left side – left arm extended – when I came down. I thought it had healed up with no problems… and maybe it did. But a couple of months ago, that same shoulder started bothering me. Lost range of motion, hurt to lift it out in front, etc. I slammed the trunk of my car shut and the pain almost took me to my knees. Saw my orthopedic surgeon (knees, neck, etc) and got an MRI. The results are: 1) “Tendonosis of the supraspinatus tendon with a focal full thickness tear identified at the anterior aspect of the tendon at its attachment to the great tuberosity. High grade partial tear versus full thickness tear is identified elsewhere within the anterior portion of the tendon.” there is also some suspicion of a partial tear extending to the bursal surface of the tendon posteriorly. 2) “Abnormal signal within the subscapularis tendon compatible with tendinosis. Partial tear is a consideration as well. No evidence of a full thickness retracted tear.” 3) Abnormal signal within the biceps labral complex as well as between the complex in the underlying glenoid. Degeneration and/or tear in this area is suspected.” And finally 4) Hypertrophic degenerative changes of the acromioclavicular joint.”

    I assume that is the AC joint that I damaged playing ball. Will PT help this or am I doomed to have surgery, even if it is arthroscopic? If surgery is recommended, what is the prognosis for recovery? I go back in to see my surgeon on Monday to get his diagnosis/recommendation but was trying to get some info before I went it. I trust him completely – been working with him for several years. I am an older guy (63) who played sports his whole life – football, softball, lacrosse, running, ultrarunning…. things are just wearing out. I knew this would happen at some point but was hoping for later rather than sooner.

  38. Reply Shani says:

    Dr Luks, I had a bad fall with all my weight landing onto my left shoulder 7 weeks ago. The first day I could not lift my arm at all and the pain was severe. A couple days later what looked like a large black bruise developed on my bicep. The ‘bruise’ did not hurt or feel tender if I touched it. I think it may have been from some internal bleeding in my shoulder that pooled in my arm, is that possible? I have some more motion now but still have quite a bit of pain even when resting. If I try to lift my arm or pick even a glass of water up, the pain is severe. After researching on the web, it seems likely i have a torn rotator cuff but I don’t know the extent of the tear. I am a runner and tried to keep running when I first hurt it then developed terrible muscle spasms in my back, I think as a result of my gait being off from the shoulder injury, so I am totally incapacitated at this point. I have been out of work for a year and have no health insurance and no money to pay cash for medical care. I am worried if I don’t get treatment that I will make it worse and have permanent damage to my shoulder. Is there anything I can do to prevent further damage and treat it on my own without any medical care? The only care I could get would probably be ER visit but it doesn’t seem like they would be able to do much except refer me to a primary care doc or ortho surgeon. Any advice you have would be helpful. Thanks.

    • Reply Howard J. Luks, MD says:

      Shani .. Sadly, the injury mechanism you sustained can cause a rotator cuff tear. It’s not a guarantee, but a possibility. I can not recommend any specific treatment recommendations other than simple stretching until you know what the actual diagnosis is. Perhaps you can visit a hospital clinic which offers care to the un- or underinsured? Once we know the diagnosis, then a treatment plan can be put into place.

  39. Reply Steve Q says:

    Dr. Luks,

    Separated my shoulder about a year ago playing basketball. Orthopedic in Stamford CT diagnosed me with a high Stage 2/low Stage 3 separation that did not require surgery. I lift weights at least 3 to 4 days a week but still have pain doing any sort of chest work (Bench Press, or any other chest exercise). I feel weakness and slight pain when i raise my arm directly in front of me. Could this be a rotator cuff issue? I usually have no problems doing pull ups, back exercises, and shoulder presses.

    • Reply Howard J. Luks, MD says:

      Steve.. sometimes the rotator cuff or other structures in the shoulder are injured when you sustained your AC separation. In addition, a small percentage of people who have a grade 2 or 3 separation will have pain relating to the AC joint. A good exam should be able to tell you which is the problem, and what the potential solutions are.
      Howard Luks

  40. Reply lana says:

    I’m having surgery 12-12-13. Can you tell me if this for sure needs surgery. I’m in awful pain & just dont think I can go any longer like this. I have been taking naproxen which absolutely helps. I feel that my visit with Dr went so fast that I didnt get to really ask anything.
    Can you please tell me what this all means?
    MRI reading
    There is a slap tear
    There is high-grade articular sided an intrasubstance tear of the supraspinatus tendon which may have focale full-thickness extension. There is associated tendinosis.
    There is a moderate grade intrasubstance tear of the subscapularis tendon w/associated tendinosis & mild medial subluxation of the tendon of the long head of the biceps into the subcapularis tendon.
    There is mild tendinosis of the infraspinatus tendon.
    There are mildly degenerative changes & a moderate amount of fluid in the subacromial-subdeltoid bursa.
    One more thing Id like to ask, if this report is bad, would this explain pain down the front of my chest?
    Thank You for any help

    • Reply Howard J. Luks, MD says:

      Lana… I have to ask.. if you’re not sure what is wrong… and you’re not sure what the doctor is doing or whether or not it is absolutely necessary then why are you having surgery and not seeking another more valuable opinion. The findings on your MRI are not uncommon — very very very few people have “normal” MRIs. Any number of things might cause pain.. but we treat patients and not MRI findings. What I mean is that your doc needs to have a solid understanding of what hurts so he knows what he needs to address. Is he/she performing a labral repain? Why? (few people need it)… Is he/she performing a rotator cuff procedure? How are they going to address the biceps in the front of the shoulder? These are all very important things to explore with a surgeon who is willing to sit down with you and explain what your options are and help you make an informed decision… and have a clear understanding about the prognosis and recovery is.

      I hope this helps!
      Howard Luks

  41. Reply nebojsa says:

    I injured and dislocated my shoulder at a MMA match.. i fell on a outstreched arm. I never had problems with that shoulder, i had problems with the other one, witch by now healed. sometimes i fell it tearing while performing a front jab and it goes away in a day or two… But i can lift 308 lbs/140 kg on bench press with no problem what so ever… heavy weights don’t botter me. Can somebody please give my an advice what should i do. I did an x-ray when i first injured it and it came as ok…

    Thanks. (sorry for bad english)

    • Reply Howard J. Luks, MD says:

      You may be having pain because of a labral or cartilage tear which occurred when you dislocated your shoulder. These tears are very common after a dislocation. One of the problems with this type of tear is that you might have recurrent instability where the shoulder is trying to slide out of place with certain maneuvers. I would suggest that an evaluation by a good shoulder doc and a possible MRI at a good facility would be the next step.
      Good Luck
      Howard Luks

  42. Reply Robert Jones says:

    Hi, thank you for this incredible website. Around 1 1/2 years ago I started having incredible pain a few hours after bench pressing.

    To start with I’ve had trouble with my left shoulder since I was a kid and fell down a tree. When I tried to catch myself I hurt my shoulder. It eventually got better, and I didn’t think anything of it until just recently.

    The pain I described after benching was not evident while I was bench pressing. It was only a few hours afterwards that I began to feel it. At the time, I took a few days off and felt better, so I tried benching again. This time, a few hours later it was worse than ever and I experienced a numbing sensation in my left hand specifically my left thumb, index and middle fingers. This lasted 6 to 7 months.

    I took around a year off from lifting weights and had moderate atrophy in my left triceps and pectoral muscles. 6 months ago I began lifting again, but went from 100 pound dumbbells pre-injury to barely being able to bench a 50 pound dumbbell with my left arm for one repetition. I’ve worked really hard and have managed to do 5 to 6 repetitions with 65 pounds now, but after 6 months I was hoping for more progress.

    I went to a generalist after the first injury, but was given Motrin and sent on my way. I’m sure I could benefit from surgery, but I would like to have an idea on what I might be in for. Thank you for your reply!

    Robert Jones

    • Reply Howard J. Luks, MD says:

      Robert…
      Thank you for the very kind comments!
      Your probably injured your labrum as a child… but I doubt that it what’s bothering you now. Most adults who work out often have pain because of their rotator cuff, or a little joint on top of the shoulder called the AC Joint. It would help me a lot more to know where the pain is. It also sounds like it’s time to see a sports doc and potentially have an MRI. The numbness and tingling is something else altogether… either a case of carpal tunnel syndrome or a problem with the nerves coming out of the neck ???

      Come back and fill me in!
      Howard Luks

  43. Reply Name Jeff says:

    I have constant pain in my arm. It is constant, a 6-8 pain level. I have osteoarthritis of the glenohumerl head.
    The long head of my bicep tendon is not visible in MRI, and the supraspinatus tendon is torn and retracted. Is there any hope that I can have someone fix this mess so I can get off of high dose morphine?
    Thank you,
    Jeff

    • Reply Howard J. Luks, MD says:

      Morphine is a very poor choice for managing chronic arthritic pain. There are treatments for patients with osteoarthritis and poor rotator cuff coverage. Find a good shoulder specialist in your area who can evaluate you and apprise you of your options.
      Good Luck Jeff

  44. Reply NameLorri says:

    Hi, my name is Lorri and I have been dealing with a rotator cuff tear for over 13 years. At age 56 now, it has started to give me massive pain. They did an MRI and found a tumor in my bicep Tendon sheath. They removed it and I still hurt from the surgery over 3 months ago. I had been on pain medicine for over 4 years with this arm and I had enough. They scheduled me for surgery to fix the first surgery because now that hurts worse than before. The surgeon stated that it is because it has now fraged away and he just wants to cut it and let it attach itself back to something instead of anchoring it down. Okay then I have a full-thinkness tear on my supraspinatus tendon and two partial tears they say in the back of my shoulder. I cancelled surgery and started to work out pretty hard. Today, I have full range of motion back; yes it hurts almost everyday, but the pain level is something I can live with. Having the surgery to me, was not the fix. I built up my muscle and have learned to do things in order to keep the pain down. Maybe later now I will really have to have another surgery but for now, I am NOT going through that pain after surgery. Good luck to everyone and I hope reading this gives you choices to make.

  45. Reply Name debbie says:

    Hi, my name is Debbie. I tripped and fell and hit my shoulder onto a pavement with my right hand in an awkward position. The first initial diagnosis by the ER doctors was just a shoulder strain. However, I could not lift my right arm up in front nor to the side. I went to see an Ortho doctor and he suspected a torn rotator cuff due to weakness. I had an MRI done and the results is a full-thickness full width tear of the supraspinatus and infraspinatus tendons at the footprint with retraction 10 mm lateral to the glenoid. Mild to moderate atrophy and fatty infiltration of the supraspinatus and infraspinatus muscles. I never had any shoulder problems before. My Ortho doctor recommends arthroscopic surgery to repair the rotator cuff. I was hoping to get surgery this week thus 4 weeks since injury, but could not because there were no openings. I am having the surgery at the end of this month which would be 6 weeks since my injury. My concern is that since this is an acute large rotator cuff tear, If I don’t get surgery within a certain timeframe the rotator cuff might not be repairable and outcome not too good. What’s your thoughts?
    When should one get surgery after experiencing acute traumatic injury which tears your rotator cuff completely in order for it to be repairable and good outcome? Could a delay in surgery promote more atrophy and fatty infiltration of the supraspinatus and infraspinatus muscles and bigger retraction of the tendon so that it is harder to repair and outcome becomes less desirable?

    Thanks,

    Debbie

    • Reply Howard J. Luks, MD says:

      Debbie .. Sorry about your injury. Kudos for doing your research! Another two weeks should not make a big difference. 2 cm of retraction is not insignificant, but an accomplished surgeon should be able to repair it.

      If you’re comfortable with your surgeon, you should be ok with waiting another few weeks.
      Best of luck
      Howard Luks

  46. Reply Vicjel Ingal says:

    What should I be expecting after I get my right shoulder surgery? Doctor says it is a 5mms tear, though that was 4months ago. Now I believe my tear surpass 5mms due to heavy lifting work, construction, and have this tear for a year now.
    I will be having the surgery by Summer 20014 and the doctor said it’ll take at most a month process to get better.
    though within that month, what will I be experiencing and when I should I be able to return to my Lifting weights routine?
    Thank you for having your time to reply.

    • Reply Howard J. Luks, MD says:

      a 5 mm tear is really really small … are you having surgery because other treatments have failed? I would also be very very cautious about thinking that you will be back to “normal” in one month. Most rotator cuff repair patients will tell you in took them 4-12 months or more to “get better” .
      Good Luck… but consider a second opinion

      • Reply Vicjel Ingal says:

        I got my MRI scan result September 2013 and it was 5mm.
        Reason why doctor should fix my tear is because any treatment they gave all failed. The ibuprofen, Injection Steriods shot direct to the tear and many more. So only way to get better is surgery as they stated.
        My Ligament/Labrum is what got torn, to clarify that.
        Though I am curious what I will be facing after the surgery?
        of how u said 4-12 months to get better, will I be able to do small resistance weights? Or suggest a different excerise after my surgery?

  47. Reply Michael says:

    I was just diagnosed with full thickness tear, 12mm in length. also hypotrophy of acromioclavicular joint. I have a friend who is a retired orthopedic surgeon tells me the tear may not be giving me all the night pain ,but the hypotrophy of the joint is. At times I have full movement of my shoulder and times I need to support it with other arm. Night pain has been constant and almost unbearable. My friend says that fixing the joint may be all that has to be done. Fixing the tear is a long hard road. Advises me to see surgeon for second opinion. What are your thoughts?

    • Reply Howard J. Luks, MD says:

      Hi Michael…
      Many many people have ACJ arthropathy- or arthritis on their MRIs. Most of them do not have pain in the AC joint. Just because it is arthritic doesn’t mean it’s going to hurt. The rotator cuff is the number one offender around the shoulder when it comes to night pain. The night pain can be awful. As very easy way to determine if the AC Joint is the source of your pain is to have your doctor examine you, and possibly inject it with lidocaine. IF your pain goes away then the ACJ is part of the problem. If your pain does not go away then the rotator cuff is the likely cause of your night pain.

      Hope this help.
      Good Luck

  48. Reply mir says:

    hi there! I had experienced a fall year ago which caused massive pain in my shoulder i had an x-ray and no bone damage but i cant play cricket or any sport that requires the rotation of the arm with a jerk i hear a pop sound and my should feels like its been dislocated and then i hear another pop and the arms all fine but it hurts for a week then is it rotator cuff damage? If it is then is it a partial tear? Acute or worse? Do i require surgery

    • Reply mir says:

      oh and i want to add that i can reach objects far away or on top shelves of a cupboard but i can not play sports

    • Reply Howard J. Luks, MD says:

      Mir… sounds more like a case of instability where the joint may be dislocating and then reducing itself. Please see a shoulder specialist.
      Good Luck

  49. Reply Why Do Shoulders Snap or Pop? Howard Luks, MD Westchester County NY says:

    […] on other ligaments or structures in the shoulder.  This may lead to painful snapping or popping. Click here to help determine if you have a rotator cuff tear?   Click here to learn more about rotator cuff […]

  50. Reply Diane P says:

    Hi Dr. Luks,
    I would like your advice regarding my rotator cup tear. I went to my doctor yesterday to go over the results of my MRI. I’ve been having pain in my right shoulder and below the shoulder for over a year now. I injured the shoulder while cleaning out horse stalls.

    I did some physical therapy back in April–before the doctor ever took an MRI or X-ray; The therapy didn’t help as it was geared towards shoulder impringement and it started to hurt when I would use the rubber band.

    The doctor said I most likely had an incomplete tear of the rotator cuff along with Calcific Tendonitis. Then, he left it at that and told me to take some Advil to relieve the pain. He didn’t suggest the surgery because I have ITP (now in remission–platelet disorder). I did say that if I did have surgery I would have to be admitted into the hospital just in case my platelets started to fall; otherwise, I would be a little scared of the surgery.

    I am 65 years old and am very active for my age. I swim, workout, and ride horses. I really would like to do something about this constant pain and was disappointed when the doctor didn’t suggest some more PT or something else. I am really tired of just “dealing” with it.

    What are your suggestions? I am right now looking for another Orthopaedic doctor to get a second opinion (and, by the way, the doctor spend probably 5-8 minutes with me going over all of this).

    I would appreciate any of your advice.

    Thank you,
    Diane

    • Reply Howard J. Luks, MD says:

      Diane… I’m not quite clear. Did the MRI show a full or partial rotator cuff tear? If it showed calcific tendonitis.. and the X-ray should show that quite clearly then you may want to discuss an Ultrasound guided injection to wash the calcium out of the rotator cuff. Calcific tendonitis is a well documented cause of significant shoulder pain.

      Good Luck
      Howard Luks

  51. Reply Duncan says:

    Hello! I have looked through the other questions and information on your website but can’t find anything relating to my specific question.
    I first injured my shoulder around 7 months ago benchpressing(Although I don’t remember a specific time it happened so it could have been an overuse injury). Anyway because it was summer and the pain was very mild I (foolishly) continued to play sports including soccer, badminton, and volleyball. Whilst playing I had a full range of motion, full strength and felt almost no pain, however usually the next day my shoulder, back and pec muscles would hurt a little. I even occaisionaly tried weightlifting however whilst I was still able to lift the same weights, it was the only activity that really caused pain during the activity.
    When summer ended I decided to see a doctor and he told me to rest for a few weeks and it should be ok, I did this and most of the muscle pain went so I started playing soccer again however after a couple of weeks the pain started to come back. It was around this time that I noticed that my collar bone was very uneven and seems to be sticking out/up at the sternoclavicular joint. At times I have felt it pop when I move my shoulder in circles(no pain). I went to the doctor again and he gave me anti inflamitory medicine and told me to rest. However I have been resting it again for a while and whilst at first it felt like it was getting better, during the last few weeks the recovery has come to a bit of a stand still with a few pain free days being followed by a few days where I can feel different things(shoulder muscles, pec muscles, clavicle). A few things I will add are:
    I still have a full range of motion.
    The problem isn’t pain so much as my muscles and shoulder just don’t feel right.
    I tried some rotator cuff exercises using v light weights but it seemed to make the feeling worse(especially near the clavicle).
    I can pick things up ok, however my shoulder gets tired very quickly. Even with things such as 1L milk cartons.
    The reason I am asking here is that I live in korea and it is very hard to get the specifics of my situation across to the doctor.
    I am a 25 year old male.
    When testing my shoulder it was the exercise where he pushed my hand down while i lifted it up straight in front of me that caused the most pain.

    Anyway sorry about the long message my questions are.. Could an injured rotator cuff have somehow displaced my clavicle?
    Is it normal for my shoulder recovery to feel like it is coming to a standstill/getting worse, even though I haven’t exercised?
    Should I have waited for the pain to have completely stopped before doing rehab exercises?

    Again sorry for the long message I have tried to add as many specifics as I can. If you feel like you can answer any of those questions I would be very gratefull!.

    Thank you,
    Duncan.

  52. Reply mike says:

    I slept on my left side and in the morning my shoulder was almost non useable. It has taken a couple weeks to feel better but still not completely. Could sleeping on ones shoulder cause a small tear or is this more likely bursitis or something?

    • Reply Howard J. Luks, MD says:

      Sleeping on our shoulder will cause other pre-existing issues to “light-up” or hurt. Sleeping on your shoulder is not a cause of rotator cuff tears.

  53. Reply Name Britt says:

    I lifted a large mop bucket with ice in it at work and felt some pain in my shoulder and neck. I have been to the doctor and she thought possible rotator cuff tear because I cannot raise my arm out or up. It will get out and up if someone else does it, but I cannot do it myself. It’s been 2 weeks and I’ve been on muscle relaxers and pain pills, but nothing has helped. The pain is pretty bad. My work is now saying it’s ok to get a MRI, which my doctor wants.
    Does it sound like a torn rotator cuff? I am having trouble sleeping due to the pain.
    Thanks.

  54. Reply JOHN says:

    I fell a couple days ago and hurt my shoulder.I played football my whole life and always got what we call stingers with shooting pain followed by a numbing sensation. I didnt think much of it. But I can only move my arm level with my shoulder with pain in my shoulder front and back with it radiating through my collar bone. It is hard to even lift a bottle of soda to my lips. Any idea what it could be.

    • Reply Howard J. Luks, MD says:

      John.. Time to see an orthopedist who specializes in shoulders sooner rather than later. This could be a rotator cuff issue …
      Howard Luks

  55. Reply Frederic says:

    Dr. John I am 70 years old and have been diagnosed with a rotator cuff tear of my right shoulder. I feel an acute pain when I lift my arm sideway, except when it is extended. I have no pain when combing my hair, bringing my arm behind my back, raising it above my head or even lifting, as long as I keep my arm straight. I do have pain however when trying to put on my sweater and removing it. I have pain when I make a swift movement trying to grab something. I did 6 sessions of physiotherapy with a little improvement. The MRI showed a tear in two tendons. The doctor said I can live like that while managing the pain, but ideally I should do the surgery, understanding that for 6 weeks my arm will be blocked in a sling and rehabilitation woud take a good 6 months. I do a lot of yard work since I’m retired… in your opinion and based on my inputs, should I do the surgery? Thank you in advance for your kind feedback.
    Frederic

    • Reply Howard J. Luks, MD says:

      Fred… I’m sorry, the rules state that I am not able to offer specific treatment advice. Much more information is needed about the type/location of the tear, failure of non-surgical measures, etc… These are issues that your surgeon needs to consider when making recommendations. Not all tears need surgery… and your recovery could be longer than 6 months in some instances.

      Good Luck
      Howard Luks

      • Reply Frederic says:

        Thank you Dr Luks,
        I am going to ask to talk with the surgeon one more time, because I am somewhat nervous about doing the surgery and also about not doing it. We’ll see.
        Kind regards and thank you for getting back to me.
        Frederic

  56. Reply Jose says:

    I’m glad I found this web site.
    I had an MRI 4 months age that showed a small tear of the Supraspinatus and Subscapularis tendon ,but with no retraction. Probably from swinging the golf club so much over the years I’m 58 years old. I opted for PT and after 4 months I have seen some improvement but I’m still experiencing some pain at night. Will this pain eventually go away or should I consider surgery.

  57. Reply Jose says:

    I had an MRI taken 4 months ago which indicated I have a small full tear of the supraspinatus and subscapularis tendon, but with no retraction. Most likely from all the golf swings I have taken over the years, I’m 58 years old. I been doing light PT since then with only minor improvement but the paint at night won’t go away, some nights are better then other but is almost every night. Will this pain at night go away eventually or should I consider surgery.

    • Reply Howard J. Luks, MD says:

      Hard to say Jose… night pain is what drives most patients to consider surgery. unfortunately night pain is not always improved by surgery. I would suggest you talk this over with your surgeon.
      Good Luck
      Howard Luks

  58. Reply Martin says:

    There is a lot of information on the internet about the timing of surgery for a complete acute trauma-related rotator cuff tear. Some say it should be done within 3 weeks, others within 3-4 months, while others recommend that you should try PT for at least 6-12 months before even thinking about surgery. Is there a time-frame within you should get your surgery done?

    • Reply Howard J. Luks, MD says:

      Actually the treatment of Acute traumatic tears is not very controversial…. to minimize the risk of retraction and fatty atrophy… and in the proper context (health, activity level, etc), fixing them sooner rather then later is preferred.

      Howard Luks

  59. Reply Anita says:

    I lifted a heavy bag over my head at work and felt a pinch and burn type of feeling in my left shoulder
    There was no pain. The next morning I woke with a terrible headache, I went to work, came home and went to bed. When I got up the next morning I had some pain in my left shoulder. Within 2 days the pain was so bad I went to emergency. There they did different tests and said it was a tear to my rotator cuff. I am wondering if I should have had pain right away or is this something else

    • Reply Howard J. Luks, MD says:

      Interesting question… sometimes the pain from a tear occurs immediately … sometimes it is delayed until the inflammation sets in. That being said, many people have rotator cuff tears and do not even know it. That means there is a chance that you had a tear before the incident — and now the tear is painful from the lifting ??

      Good Luck
      Howard Luks

  60. Reply Steve says:

    Hello … I recently had an MRI which revealed a 9mm full thickness tear of my rotator cuff. The tear occurred back in December from a fall playing recreational hockey. My doctor has recommended surgery to repair the tear and I’m a little hesitant to move forward with surgery (and the recovery). I’m 40 years old with very active young children (under 10 years old) and also want to continue playing hockey. I experience very little pain during my daily routine and only certain activities/motions are painful .. like sleeping on that shoulder or the motion to put coat on. And even then it only lasts a short while. In the opinion of my doctor (at my age and activity level), it would be a mistake for me not to have the surgery. The surgery is scheduled for the end of March, but I’m still not sure I want to move forward with it.

    What do you think?

  61. Reply josh says:

    I have constant clicking and snapping down the middle of my shoulder…I get tired quickly and it starts to burn like after a long workout with just lifting my arm up. do you think I should consult an ortho?

    • Reply Howard J. Luks, MD says:

      YEs Josh… If this has been going on for more than a few weeks I would visit your Orthopedist.

      Howard Luks

      • Reply Nilesh says:

        I woke up one morning and my shoulder was sore. Next day i went to a Gp who gave me medicine for it. Two weeks later. Nothing. No swelling but still can’t lift anything heavy without my left shoulder shaking. Went to the chiropractor. 4 sessions later still the same. Went to a physio but after 4 sessions. Still the same. Went to a nerologist and he couldn’t find anything. Went to a ortho doc he says i must go to a neurologist. What should i do. I only get paid when i lift heavy objects. I keep on sleeping on my arm. I think that could be how i hurt it. What should i do as i cannot gym anymore.

  62. Reply MB says:

    Fascinating information on your website! Reading the posts has compelled me to ask your opinion. I hurt my shoulder 6 months ago after holding a cordless drill in an overextended and ackward position for hours. Pain occurred with overhead motion and sleeping was terrible. I consulted an orthopedic surgeon in January. Based on an X-ray showing no bone damage and the evaluation of my arm movements and pain level my physician had me go home and perform shoulder stretches for a month. Upon return (although nowhere near original state there was minor improvement) an MRI was performed that showed a labrum tear. Although my physician was very indecisive about the injury prior to the MRI, after the results he was quick to say my best option was surgery using anchors to stabilize the labrum. He stated that PT was unlikely make a substantial improvement and that if I did not opt for surgery I would endure arthritis later. I have surgery scheduled for April but now I am second guessing it since my pain has reduced with time and I not big on the idea of having healthy bone drilled to mount anchors. I am 38 years old and exercise daily. Any thoughts ?

    • Reply Howard J. Luks, MD says:

      MB .. By you limited discussion regarding your complaints it is unlikely that the labral tear is the source of your pain. in addition… it is simply NOT TRUE that having a labral tear will predispose you to developing arthritis. If your pain is improving you can chose to be observed and see how things progress. This is not an urgent matter…

      Good Luck
      Howard Luks

  63. Reply Name Teresa says:

    I am 4 weeks out from surgery on my left shoulder for labrum tear and partial rotator cuff tear. The nurse called this shoulder impingement. The surgeon did not do any repair,instead: he smoothed out the labrum, cleaned up, debrided, and manually broke up my frozen shoulder. Previous to surgery I had been experiencing intense pain when reaching behind my back or to my left side. I have been in PT since day 1. One week ago I started experiencing intense pain with movements to my right front side. Also, pain is radiating to my pectoral muscles. Is this a normal part of healing for this type od surgery? Thank you.

    • Reply Howard J. Luks, MD says:

      It is not outside the realm of possibilities. The majority of labral abnormalities beyond a certain age are not “fixed”, since it can cause stiffness and the failure rate can be high. Also.. most labral abnormalities after a certain age are usually degenerative in nature (us wearing out our parts).

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